Fewell Eye Clinic

NPI 1861517682 - Optometrist - 152W00000X

NPI Details
NPI 1861517682
Enumeration Date 03/20/2007
Last Updated 01/15/2009
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name R MICHAEL R
Position OWNER
Phone (765) 455-0404
Fax (765) 455-1765
Practice Location
3421 S LAFOUNTAIN ST
SUITE A
KOKOMO IN, 46902-3852, US
Phone (765) 455-0404
Fax (765) 455-1765
Business Location
PO BOX 2767
KOKOMO IN, 46904-2767, US
Phone (765) 455-0404
Fax (765) 455-1765
Toxanomy
Taxonomy Code 152W00000X
License State Indiana
License Number 18001678B
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According to our database, Fewell Eye Clinic NPI is 1861517682, taxonomy code is 152W00000X and license number is 18001678B, license state is located at Indiana. Fewell Eye Clinic physically located at 3421 S Lafountain St, Kokomo IN, 46902-3852. NPI Number 1033115704 has the healthcare provider type.

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1861517682 NPI number is provided on an as is basis without warranty of any kind. 1861517682 is maintained by the National Plan & Provider Enumeration System. The contents of Fewell Eye Clinic are for informational purposes only.